The Affordable Care Act, known to many as Obamacare began enrollment efforts this week. In recent months my patients have asked me what will happen to them under these new health care laws and legislation. Although I cannot say for certain what will happen, I can make some educated guesses based on the content of the legislation.
In the short term, nothing should happen to the care you receive. You will still be able to visit your doctor of choice, receive surgery and important injections, and fill your prescriptions.
In the long term, I feel things will change significantly and for the worse. As full time employees lose their health benefits or are converted to part time employees, more and more people will be forced to enroll in state or federal sponsored programs. In order to maintain the low premiums we all pay for health care coverage, there needs to be a significant reduction in costs to insurance carriers. This means fewer allowed procedures, limitation on the name brand medications you receive, and more.
As a result of Obamacare, it has been estimated by physician recruiters that more than 50 percent of physicians will retire early. As office-based pain management becomes less profitable (remember pain management centers employ nurses and administrative personnel, as well as rent and other expenses out of the money paid to physicians) many anesthesia-based pain providers will return to the operating room. This will force more and more patients to fewer physicians. This will result in longer waiting times and could very likely result in pain management physicians ceasing to accept any insurance.
The use of prescription medications to treat and manage chronic pain will continue, but will likely be limited to cheaper generic medications. For most patients this will not be a problem but for others with allergies or who need newer medications there will be no other options available.
In short, I am concerned about how Obamacare will impact legitimate pain management practices and the patients who require our assistance. Ultimately, I fear we will have a two-tiered system, much like we see in the United Kingdom, where patients who have government insurance experience long waits and limited services, while patients who can pay cash will have the same care you once had.
Welcome to socialized medicine.
Dr. Marc Valley, MD is a board certified anesthesiologist and a pain management specialist who received his training in the Air Force and at Johns Hopkins University. Dr. Valley is the founder of CIRCE Medical Services, a Chattanooga-based pain management practice. He has practiced for over 25 years in the fields of interventional and non-interventional pain management.